Spinal Cord Stimulator Injury Lawsuit
WHAT IS A SPINAL CORD STIMULATOR?
Chronic back pain is a common problem facing many Americans today. Those who deal with this all-consuming condition generally begin their fight against the pain using conservative measures, such as over-the-counter painkillers, acupuncture, steroid injections, and chiropractic treatments.
As history has taught us, however, prescription painkillers bring with them a host of side effects and addiction issues. As a result, many physicians counsel their patients on the benefits of spinal cord stimulators. A spinal cord stimulator is an implantable, paddle-shaped medical device that treats chronic pain through the emission of electrical impulses near the spinal cord. These impulses produce a tingling sensation that alters the perception of the pain. The device is implanted into the epidural space (outermost area of the spinal canal, above the cord and dura) through either a percutaneous approach (using a wide-bore needle to insert the stimulator into the epidural space and advance it to the proper location) or through a surgical laminectomy/laminotomy approach (requiring the removal of the bony spinous process and the insertion of the stimulator into the epidural space through an incision in the ligament that protects the spinal cord. The stimulator is then sutured into place and is controlled by a pulse generator that is usually implanted in the patient’s hip. The device can be controlled remotely by the patient as his/her pain dictates.
THE RISKS ASSOCIATED WITH SPINAL CORD STIMULATORS
While there are numerous risks associated with this surgical procedure (as there are with any surgical procedure), paralysis is not an accepted complication in most instances. Accordingly, if a patient suffers some degree of paralysis, they physician may have committed malpractice.
First, the standard of care for a neurosurgeon who is placing a stimulator is to protect the spinal cord from injury while placing it in the epidural space. In the context of a patient who has previously had a stimulator placed, this risk is more magnified. For example, in such patients, a surgeon should expect to encounter scar tissue/epidural adhesions in the epidural space at the time of surgery. This scar tissue makes it difficult to insert the paddle stimulators to the desired spinal level. To the extent that a physician “pushes” too hard against the scar tissue, the stimulator may “buckle” or deviate downward into the spinal cord contusing it and causing paralysis.
In addition, in some instances as the doctor tries to “free up” up the scar tissue with surgical tool to create a path for the spinal cord stimulator to move into place, a careless motion with the tool can result in contact with the cord and subsequent paralysis. Sadly, under either scenario, the result is a lifetime of needed care for the patient due to the irreversible paralysis.
SPINAL CORD STIMULATOR LAWSUITS
During these cases, our attorneys point to the fact that the epidural space (the area within which the stimulator is placed) is only millimeters wide with the spinal cord lying immediately below it. We point out that the spinal cord itself is essentially the consistency of wet pasta, and therefore, can be easily injured if contused by surgical instruments or the paddle leads with any degree of force. What we have discovered is that in many of these cases where serious injuries (paralysis) have occurred, is that the surgeon encountered resistance within the epidural space as he/she attempted to place the stimulator paddle.
This resistance is usually caused by the presence of pre-existing scar tissue within the epidural space – scar tissue which is not visible on pre-operative x-rays or MRIs. This scar tissue often impedes the pathway of the paddle – making it impossible for the paddle to be placed at the desired level of the spine. What we have unfortunately seen, is that when this occurs, some surgeons attempt to force the paddle through the scar tissue, actions which result in the paddle buckling and/or deviating downward into the spinal cord, contusing/bruising the cord and causing permanent injury. Instead of attempting to blindly force these paddles through the scar tissue, our expert surgeons testify that the safest approach, and the one that carries with it the least risk of injuring the spinal cord, is to extend the patient’s laminectomy up to the level of the scar tissue, so as to open the site and remove the scar tissue under direct visualization.